What Is True Sciatica?

Root causes of sciatic pain

​The sciatic nerve is comprised of five sets of paired nerve roots in the lumbar spine. The sciatic nerve runs from the lower back, through the gluteal and hips muscles, down each leg and into the foot. The sciatic nerve is the largest single nerve in the body. 
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Piriformis Syndrome (False Sciatica) is often confused with True Sciatica. When the sciatic nerve is irritated by the piriformis muscle, it can cause pain that is very similar to True Sciatica. 

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Since symptoms of True Sciatica are almost identical to Piriformis Syndrome, there are two chair tests that help distinguish between the two:
1.    While sitting on a chair, straighten your leg parallel to the floor on the side you are experiencing pain. If the pain increases, it is the symptom of true sciatica.
2.    Sit straight on a chair and pull your knee to the same shoulder and then to another one. If the pain gets worse, you have Piriformis Syndrome.​​

What Causes True Sciatica?
The 5 most common causes are:

• Bulging or herniated disc
• Trauma
• Lumbar spinal stenosis
• Spondylolisthesis
• Spinal tumors

Because many conditions can compress the sciatic nerve and cause sciatic pain, it's important to see your doctor, as the treatments are different depending on where and why the nerve is being compressed. 

When To Seek Immediate Medical Attention:

• Symptoms continue to get worse rather than improve, which may indicate possible nerve damage.
• Symptoms that occur in both legs or that cause bladder or bowel incontinence or dysfunction or altered sensation in the genital area.
• Sciatica that occurs after accident or trauma - or develops with other troubling symptoms such as fever or loss of appetite.

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What You Can Do To Relieve The Pain

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Exercise
Moving is the last thing you want to do when you're dealing with sciatic pain, but lying in bed all day can make the pain worse. Exercise increases blood flow and helps to relax tension in the low back and hip muscles. Try taking 15-20 minute walks. If that is too painful, swimming or water aerobics are a great option. 

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Acupuncture
Your Acupuncturist will use a combinations of treatments including acupuncture, Chinese herbs, Tui Na, and stretching. Your back, hips and pelvis will all be incorporated into your treatment. Acupuncture treatments will
reduce inflammation, improve blood flow and release spastic muscles.

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​Epidural Steroid Injections
If your pain doesn't not change or lessen within 6 months of using other therapies you should ask your doctor about epidural steroid injections. 
Because of concerns about side effects, such as loss of bone density, the epidural shots are limited to three a year. ​

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Professional Massage
Once the inflammation and pain has decreased, massage can alleviate pain and speed up the healing process. Massage will increase blood circulation and relax the surrounding muscles. 
​Make sure to let your therapist know if the pressure is too deep or painful. 

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Physical Therapy
The goal of physical therapy is to help you regain normal function that can be lost as a result of sciatic nerve compression. Your physical therapist can prescribe exercises and stretches to help restore flexibility and strengthen weakened muscles.

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Read More​
Sciatic Pain and Piriformis Syndrome

Sources
Root causes of sciatica pain